Business Analyst

• Evaluate existing claims business processes and identify opportunities to enhance efficiency, accuracy, and customer satisfaction.
• Conduct root cause analyses to uncover operational gaps, data inconsistencies, or process bottlenecks.
• Define and document “as-is” and “to-be” workflows using process mapping and related methodologies.
• Collaborate with business stakeholders, to design improved end-to-end claims processes.
• Translate business needs into functional process requirements for automation, system enhancement, or workflow redesign.
• Support implementation of new workflows, ensuring proper change management and training.
• Develop, standardize, and maintain documentation for claims-related business processes, procedures, and performance metrics.
• Ensure that claims processes adhere to company policies, best practices, and all state/federal regulatory requirements.
• Serve as a liaison between Claims and other departments to ensure process coherence and data alignment.
• Support Single Source of Truth (SSOT) initiatives to ensure consistent data usage, definitions, and reporting across systems.
• Partner with technology teams to evaluate and enhance system capabilities (e.g., Duck Creek, OnBase, ADLS, Snowflake).
• Define and track key performance indicators (KPIs) to measure process effectiveness and turnaround times.
• Prepare and present insights, findings, and process improvement recommendations to leadership.
• Support internal and external audits with accurate process documentation and data integrity assurance.
• Lead or participate in business process reengineering (BPR) and operational efficiency initiatives.
• Promote a culture of continuous improvement through feedback loops, metrics-driven decision making, and proactive issue resolution.

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